Medicine minders: tribes and sects

Within Great Britain, a strange tribe has been discovered: the medicine minders. Its division into sects particularly interests anthropologists. This preliminary report, by Malcolm Brown, may assist the compilation of a field guide.

Great Britain is a small, densely populated European island inhabited by many tribes. Medicine minders are so called because they attend to medicines: they have done so for generations. The tribe, comprising around 44,000 members, is essentially friendly. Members are sincerely dedicated to healing by meticulously minding medicines, often aided by lists. The tribe knows more about medicines than does any other tribe, even the doctors. The medicine minders are divided into six sects.


The largest sect (55 per cent) are the shopkeepers (tribal title “community pharmacists”). They are concentrated in urban areas; doctors dispense in rural locations. The shopkeepers will sell anything that is profitable, such as oven cleaner or cuddly toucans, not just medicines. The shopkeepers’ antecedents included the mercers and mercenary tendencies remain obvious. In fairness, that characteristic is normal in many island inhabitants. However, routine exchange of merchandise for actual cash makes financial orientation obvious in shopkeeping, compared with non-shopkeeping, islanders.

An increasing portion of this sect are nomads. They hire themselves out as casual, hourly-paid, landless labourers (“locums”) but retain personal autonomy. Their activity is a spin-off of the islanders’ tourism industry; locums are frequently present when the regular medicine minder is on holiday.

Many islanders visit the shops of the medicine minders. This sect is popular, their mantra of “the customer is always right” and friendly, approachable demeanour contribute to their appeal.

However, a recent trend, connected with reduction of income, is that fewer medicine minders now own their shops. Many work within the cathedral-sized stores owned by the grocer tribe. There, arguably, the medicine makers are returning to one of their roots: the medicine minders fragmented from the grocers around 15 generations ago. This loss of autonomy matters and will be noted among other sects.


The next sect (15 per cent) is the infirmary suppliers (“hospital pharmacists”). Their location is usually clinics, hospices and infirmaries where sick islanders go who, generally, need care only available in such sites.

This sect possesses particular skill in tailoring medicines to the needs of the infirmary residents, or to use the tribe’s vernacular, in “clinical pharmacy”. Indeed, those skills are so profitable that they have been exported to other sects, notably the shopkeepers. However, unlike the shopkeeper sect, who seldom have the doctor tribe working within their buildings, infirmaries are densely colonised by doctors who, in that setting, are dominant over the medicine minders.

Moreover, elders of the infirmary suppliers experience conflict when their aspirations for the best healing collide with the imperatives of the administrative tribe. This reflects a recognised generic fault line between professionals and managers. Today, the administrative and allied accountancy tribes increasingly dominate the infirmary suppliers, who derive much of their power from minding that medicines are used cost effectively.


The next sect is the mill workers (“industrial pharmacists”), comprising only 5 per cent. Geographically, most members cluster around the metropolis. However, this sect does travel widely off-island, generally earns more and has higher academic credentials than most other sects. However, the shopkeepers and infirmary suppliers look down on mill workers because they seldom meet patients face-to-face. This is normal; any particular sect will consider itself superior and disparage other sects.

Although seldom encountered, the mill workers are an important sect. The reason is that they invent, research and develop the physical medicines that the other sects need for minding. Generally the other sects have forgotten how to make medicines.

However, on the advice of the accountancy tribe, the mills employing the mill workers are merging and one resulting economy is that fewer workers are required. Some early mills started in the back of
(work)shops owned by members of the medicine minders. However, a recent trend has been competition by the tribes of biologists and chemists. These may accept lower initial income, being ineligible for the higher initial income of the shopkeeper sect.


The tower dwellers (“academic pharmacists”) are an even smaller sect, comprising just 1 per cent of the tribe. They concentrate in ghettos, often possessing towers. Tower dwellers view themselves as an elite but other sects disparage tower dwellers as too cocooned from the real world by their towers.

But tower dwellers are a vital sect. As “elders”, they select suitable young islanders and offer them books and experiments that are kinds of burr and will stick — so passing on tribal knowledge, skills and customs.

Elders then examine youngsters and those deemed suitable are passed to other “elders”. Eventually, the tribe orchestrates formal initiation rites into membership, culminating in the presentation of certificates. These are so profoundly symbolic that they are only loaned to the members and must be returned on banishment or death. The tower dwellers, therefore, make an essential contribution to moulding all sects.

Generations ago, some tower dwellers managed their own private schools for initiation. Today, tower dwellers have dwindled into a tiny part of enormous institutions directed by tower dwellers from other tribes, such as chemists or politicians.


The scribblers (“pharmaceutical writers”) form a tiny sect. They mainly inhabit the metropolis and the south of the island, although a few are nomadic, being paid by the word. Their writing ranges from weekly ephemera to a well-informed tome that claims to be “The complete drug reference” that is widely accepted, including by doctors.

The scribblers matter for communication within the tribe and to enhance tribal relationships with other islanders. Proverbially, pen and ink are wit’s plough.

Even within this enclave, outsiders have penetrated the tribe. For the tribe’s largest circulation weekly periodical, its official organ, an outsider was judged to be a better scribbler-in-chief than any insider. Some tribe members believed that an outsider in that position broke a taboo and were sufficiently outraged to call an extraordinary meeting of tribal members. However, at that assembly, the outsider was voted to remain as a mercenary judged to best serve the tribe’s interests.


That leaves the final sect. The cabinet members (“Council members”) are the tribe’s chiefs, diplomats, oracles, sages, shamans and warriors. They exercise power over the whole tribe, aided by courtiers and itinerant inspectors who police, particularly, the shopkeeper sect. The cabinet, representing authority, is fair game for criticism by other sects.

The cabinet sect provides the starkest illustration of penetration by outsiders long having included three outsiders. Shortly, many more will probably follow as cabinet members. These infiltrations suggest that a period of turbulence lies ahead. The tribe has adapted to endure such periods before. So long as the tribe continues to focus upon medicines and leaders from outside permit that, the tribe should, in some form, survive. In case it does not, in-depth anthropological study is recommended, soon.

Last updated
The Pharmaceutical Journal, PJ, December 2002;()::DOI:10.1211/PJ.2024.1.309249

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